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Bel Ağrısında Acil Bir Durum: Kauda Equina Sendromu İle Kendini Gösteren Lomber Disk Hernisi

An Urgent Situation of Back Pain: Lomber Disc Herniation Presenting with Cauda Equina Syndrome

Journal Name:

  • Uludağ Üniversitesi Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of Author
Abstract (2. Language): 
Cauda equina syndrome (CES) as a result of lumbar disc herniation is a rare entity and surgical treatment is mandatory. Ten patients with lomber disc herniation who were presented with CES symptoms were reviewed retrospectively. There were 8 female and 2 male patients with a mean age of 52.4±11.8. The major symptom was severe back and leg pain. All patients were operated on urgently. The mean follow-up were 2.65±0.9 years. Of 5 patients who were operated within 48 hours of onset of the symptoms, a significant improvement occured in 4 (80%) patients with urine retantion and in 3 (60%) patients with perianal hypoestesia. Three of the four patients had recovery of motor deficits, and also full recovery of the sexual dysfunction in one patient. Five patients were operated on after 48 hours. There were no improvement of the urinary dysfunction of 3 patients and the sexual dysfunction in one patient. Although the matter of the timing of surgery remains controversial, a significant improvement in sensory and motor deficits as well as urinary function occurred in patients who underwent decompression within 48 hours
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Abstract (Original Language): 
Lomber disk herniasyonları nedeni ile ortaya çıkan kauda ekuina sendromu (KES) nadir görülür ve kesin cerrahi tedavi gerektirir. KES bulguları ile başvuran lomber disk herniasyonu olan 10 olgu retrospektif olarak incelendi. 8’i kadın, 2’si erkek ve yaş ortalamaları 52.4±11.8 yıldı. Major semptom şiddetli bel ve/veya bacak ağrısıydı. Hastalar acil operasyona alındı. Ortalama takip süresi 2,65 ±0,9 yıl idi. Semptomların başlamasından ilk 48 saat içinde operasyona alınan 5 olgunun 4’ünde (%80) idrar inkontinansı, 3’ünde (%60) perianal his kusuru tamamen düzeldi. 4 olgunun 3’ünde (%75) kuvvet kaybı ve bir olgunun seksüel disfonksiyonu tamamen düzeldi. 48 sonra operasyona alınan 5 olgunun 3’ünde (%60) idrar inkontinansında iyileşme olmadı. Seksüel disfonksiyon olan 1 olguda da düzelme gözlenmedi. Cerrahi alınma süresi tartışmalı olsa da, 48 saat içinde cerrahi dekompresyon yapılan olgularda duyu, motor ve üriner fonksiyonlarda belirgin iyileşme olmaktadır.
FULL TEXT (PDF): 
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  • 3
141-144
  • Turkish

REFERENCES

References: 

1. Shapiro S : Medical realities of cauda equina syndrome
secondary to lumbar disc herniation. Spine 2000; 25:348-52.
2. Ahn UM, Ahn NU, Buchowski JM et al: Cauda equina
syndrome secondary to lumbar disc herniation: A Metaanalysis of surgical outcomes. Spine 2000; 25:1515-22.
3. Anthony S: Cauda equina syndrome. Medical Protection
Society Casebook (Leeds) 2003;20:9-13.
4. Kostuik JP. Medicolegal concequences of cauda equina
syndrome: an overview. Neurosurgical Focus 2004; 16:39-41.
5. Gleave JRW, MacFarlane R. Cauda equina syndrome: what is
the relationship between timing of surgery and outcome ? Br J
Neurosurg 2002;16:325-8.
6. Tay ECK, Chacha PB. Midline prolapse of a lumbar
intervertebral disc with compression of the cauda equina. J
Bone Joint Surg (Br) 1979; 61:43-7.
7. Kostuik JP, Harrington I, Alexander D, et al. Cauda equina
syndrome and lumbar disc herniation. J Bone Joint Surg (Am)
1986; 68:386-91.
8. Shapiro S: Cauda equina syndrome secondary to lumbar disc
herniation. Neurosurgery 1993;32(5): 743-7.
9. Kohles SS, Kohles DA, Karp AP, Erlich VM, Polissar NL.
Time-dependent surgical following cauda equina syndrome
diagnosis. Spine 2004; 29:1281-7.
10. Olmarker K, Rydevik B, Holm S, et al. Effects of
experimental graded compression on blood flow in spinal neve roots: a vital mycroscopic study on porcine cauda equina. J
Orthop Res 1989; 7:817-23.
11. Nascone JW, LAuerman WC, Wiesel SW. Cauda equina
syndrome:is it a surgical emergency? Orthop 1999; 12:73-6.
12. Rydevik BL, Myers RR, Powell HC. Pressure increase in the
dorsal root ganglion following mechanical compression. Spine
1989; 14:574-6.
13. Aha AJ, Auranen A, Pesonen K : Analysis of cauda equina
symptoms in patients with lumbar disc prolapse. Acta Chir
Scand, 1969;135:413-20.
14. Choudhury A R, Taylor JC: Cauda Equina Syndrome in
Lumbar Disc Disease, Acta Orthop.Scand. 1980;51:493-9.
15. Shephard RH. Diagnosis and prognosis of cauda equina
syndrome produced by protrusion of lumbar disc. BMJ 1959;
5:1434-9.
16. Nielsen B, de Nully M, Schmidt K, et al. A urodynamic study
of cauda equina syndrome de to lumbar disc herniation. Urol
Int 1980; 35:167-70.
17. Hellstrome P, Tammela TLJ, Kortelainen P, Kontturi M. Late
urodynamic findings after surgery for cauda equina syndrome
caused by a prolapsed lumbar intervertebral disc. J Urol 1986;
135:308-12.
18. Dinning TAR, Schaeffer HR. Discogenic compression of the
cauda equina: A surgical emergency. Aust Z J Surg 1993;
63:927-34.
19. Buchner M, Schiltenwolf M. Cauda equina syndrome caused
by intervertebral lumbar disc prolapse: mid term results of 22
patients and literature review. Orthopaedics 2002; 25:727-31.
20. Chang HS, Nakagawa H, Mizuno J. Lumbar herniated disc
presenting with cauda equina syndrome long-term follow-up
of four cases. Surg Neurol 2000; 53:100-5.
21. McCarthy MJH, Aylott CEW, Grevitt MP, Hegarty J. Cauda
equina syndrome: Factors affecting long-term functional and
sphincteric outcome. Spine 2007;32:207-16.

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